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Siland JE, Geelhoed B, Roselli C, Wang B, Lin HJ, Weiss S, Trompet S, van den Berg ME, Soliman EZ, Chen LY, Ford I, Jukema JW, Macfarlane PW, Kornej J, Lin H, Lunetta KL, Kavousi M, Kors JA, Ikram MA, Guo X, Yao J, Dörr M, Felix SB, Völker U, Sotoodehnia N, Arking DE, Stricker BH, Heckbert SR, Lubitz SA, Benjamin EJ, Alonso A, Ellinor PT, van der Harst P, Rienstra M. Resting heart rate and incident atrial fibrillation: A stratified Mendelian randomization in the AFGen consortium. PLoS One 2022; 17:e0268768. [PMID: 35594314 PMCID: PMC9122202 DOI: 10.1371/journal.pone.0268768] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/06/2022] [Indexed: 12/02/2022] Open
Abstract
Background Both elevated and low resting heart rates are associated with atrial fibrillation (AF), suggesting a U-shaped relationship. However, evidence for a U-shaped causal association between genetically-determined resting heart rate and incident AF is limited. We investigated potential directional changes of the causal association between genetically-determined resting heart rate and incident AF. Method and results Seven cohorts of the AFGen consortium contributed data to this meta-analysis. All participants were of European ancestry with known AF status, genotype information, and a heart rate measurement from a baseline electrocardiogram (ECG). Three strata of instrumental variable-free resting heart rate were used to assess possible non-linear associations between genetically-determined resting heart rate and the logarithm of the incident AF hazard rate: <65; 65–75; and >75 beats per minute (bpm). Mendelian randomization analyses using a weighted resting heart rate polygenic risk score were performed for each stratum. We studied 38,981 individuals (mean age 59±10 years, 54% women) with a mean resting heart rate of 67±11 bpm. During a mean follow-up of 13±5 years, 4,779 (12%) individuals developed AF. A U-shaped association between the resting heart rate and the incident AF-hazard ratio was observed. Genetically-determined resting heart rate was inversely associated with incident AF for instrumental variable-free resting heart rates below 65 bpm (hazard ratio for genetically-determined resting heart rate, 0.96; 95% confidence interval, 0.94–0.99; p = 0.01). Genetically-determined resting heart rate was not associated with incident AF in the other two strata. Conclusions For resting heart rates below 65 bpm, our results support an inverse causal association between genetically-determined resting heart rate and incident AF.
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Affiliation(s)
- J. E. Siland
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - B. Geelhoed
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - C. Roselli
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Cardiovascular Disease Initiative, The Broad Institute of MIT and Harvard, Cambridge, MA, United States of America
| | - B. Wang
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, United States of America
| | - H. J. Lin
- Institute for Translational Genomics and Population Sciences, The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, United States of America
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
| | - S. Weiss
- Interfaculty Institute for Genetics and Functional Genomics; Department of Functional Genomics; University Medicine Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research); partner site Greifswald, Greifswald, Germany
| | - S. Trompet
- Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - M. E. van den Berg
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - E. Z. Soliman
- Division of Public Health Sciences and Department of Medicine, Epidemiological Cardiology Research Center, Department of Epidemiology and Prevention, Section on Cardiology, Wake Forest School of Medicine, Winston-Salem, NC, United States of America
| | - L. Y. Chen
- Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, United States of America
| | - I. Ford
- Robertson Centre for Biostatistics, University of Glasgow, Glasgow, United Kingdom
| | - J. W. Jukema
- DZHK (German Centre for Cardiovascular Research); partner site Greifswald, Greifswald, Germany
- Einthoven Laboratory for Experimental Vascular Medicine, LUMC, Leiden, The Netherlands
- Netherlands Heart Institute, Utrecht, The Netherlands
| | - P. W. Macfarlane
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
| | - J. Kornej
- National Heart, Lung, and Blood Institute’s and Boston University’s Framingham Heart Study, Framingham, MA, United States of America
| | - H. Lin
- National Heart Lung and Blood Institute’s and Boston University’s Framingham Heart Study, Framingham, MA, United States of America
- Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, Boston, MA, Unites States of America
| | - K. L. Lunetta
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, United States of America
- National Heart, Lung, and Blood Institute’s and Boston University’s Framingham Heart Study, Framingham, MA, United States of America
| | - M. Kavousi
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - J. A. Kors
- Department of Medical Informatics, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M. A. Ikram
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - X. Guo
- Institute for Translational Genomics and Population Sciences, The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, United States of America
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States of America
| | - J. Yao
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute at Harbor-UCLA Medical Center, Torrance, CA, United States of America
| | - M. Dörr
- DZHK (German Centre for Cardiovascular Research); partner site Greifswald, Greifswald, Germany
- Department of Internal Medicine B-Cardiology, Pneumology, Infectious Diseases, Intensive Care Medicine, University Medicine Greifswald, Greifswald, Germany
| | - S. B. Felix
- DZHK (German Centre for Cardiovascular Research); partner site Greifswald, Greifswald, Germany
- Department of Internal Medicine B-Cardiology, Pneumology, Infectious Diseases, Intensive Care Medicine, University Medicine Greifswald, Greifswald, Germany
| | - U. Völker
- Interfaculty Institute for Genetics and Functional Genomics; Department of Functional Genomics; University Medicine Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research); partner site Greifswald, Greifswald, Germany
| | - N. Sotoodehnia
- Cardiovascular Health Research Unit, Division of Cardiology, Departments of Medicine and Epidemiology, University of Washington, Seattle, WA, Unites States of America
| | - D. E. Arking
- McKusick-Nathans Institute, Department of Genetic Medicine, Johns Hopkins University SOM, Baltimore, MD, Unites States of America
| | - B. H. Stricker
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - S. R. Heckbert
- Cardiovascular Health Research Unit and the Department of Epidemiology, University of Washington, Seattle, WA, Unites States of America
| | - S. A. Lubitz
- Cardiovascular Disease Initiative, The Broad Institute of MIT and Harvard, Cambridge, MA, United States of America
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, Unites States of America
- Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, MA, Unites States of America
| | - E. J. Benjamin
- Institute of Health and Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom
- Department of Medicine, Boston University School of Medicine, Boston, MA, Unites States of America
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, Unites States of America
| | - A. Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, Unites States of America
| | - P. T. Ellinor
- Cardiovascular Disease Initiative, The Broad Institute of MIT and Harvard, Cambridge, MA, United States of America
- Cardiovascular Research Center, Massachusetts General Hospital, Boston, MA, Unites States of America
- Cardiac Arrhythmia Service, Massachusetts General Hospital, Boston, MA, Unites States of America
| | - P. van der Harst
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Genetics, Groningen, The Netherlands
- University Medical Center Utrecht, Department of Heart and Lungs, University of Utrecht, Utrecht, The Netherlands
| | - M. Rienstra
- Department of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- * E-mail:
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Deo R, Nalls MA, Avery CL, Smith JG, Evans DS, Keller MF, Butler AM, Buxbaum SG, Li G, Miguel Quibrera P, Smith EN, Tanaka T, Akylbekova EL, Alonso A, Arking DE, Benjamin EJ, Berenson GS, Bis JC, Chen LY, Chen W, Cummings SR, Ellinor PT, Evans MK, Ferrucci L, Fox ER, Heckbert SR, Heiss G, Hsueh WC, Kerr KF, Limacher MC, Liu Y, Lubitz SA, Magnani JW, Mehra R, Marcus GM, Murray SS, Newman AB, Njajou O, North KE, Paltoo DN, Psaty BM, Redline SS, Reiner AP, Robinson JG, Rotter JI, Samdarshi TE, Schnabel RB, Schork NJ, Singleton AB, Siscovick D, Soliman EZ, Sotoodehnia N, Srinivasan SR, Taylor HA, Trevisan M, Zhang Z, Zonderman AB, Newton-Cheh C, Whitsel EA. Common genetic variation near the connexin-43 gene is associated with resting heart rate in African Americans: a genome-wide association study of 13,372 participants. Heart Rhythm 2012. [PMID: 23183192 DOI: 10.1016/j.hrthm.2012.11.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Genome-wide association studies have identified several genetic loci associated with variation in resting heart rate in European and Asian populations. No study has evaluated genetic variants associated with heart rate in African Americans. OBJECTIVE To identify novel genetic variants associated with resting heart rate in African Americans. METHODS Ten cohort studies participating in the Candidate-gene Association Resource and Continental Origins and Genetic Epidemiology Network consortia performed genome-wide genotyping of single nucleotide polymorphisms (SNPs) and imputed 2,954,965 SNPs using HapMap YRI and CEU panels in 13,372 participants of African ancestry. Each study measured the RR interval (ms) from 10-second resting 12-lead electrocardiograms and estimated RR-SNP associations using covariate-adjusted linear regression. Random-effects meta-analysis was used to combine cohort-specific measures of association and identify genome-wide significant loci (P≤2.5×10(-8)). RESULTS Fourteen SNPs on chromosome 6q22 exceeded the genome-wide significance threshold. The most significant association was for rs9320841 (+13 ms per minor allele; P = 4.98×10(-15)). This SNP was approximately 350 kb downstream of GJA1, a locus previously identified as harboring SNPs associated with heart rate in Europeans. Adjustment for rs9320841 also attenuated the association between the remaining 13 SNPs in this region and heart rate. In addition, SNPs in MYH6, which have been identified in European genome-wide association study, were associated with similar changes in the resting heart rate as this population of African Americans. CONCLUSIONS An intergenic region downstream of GJA1 (the gene encoding connexin 43, the major protein of the human myocardial gap junction) and an intragenic region within MYH6 are associated with variation in resting heart rate in African Americans as well as in populations of European and Asian origin.
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Affiliation(s)
- R Deo
- Division of Cardiology, Electrophysiology Section, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
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